The international journal of cardiovascular imaging
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Int J Cardiovasc Imaging · Jan 2017
Comparative StudyEvaluation of right atrial function by two-dimensional speckle-tracking echocardiography in patients with right ventricular myocardial infarction.
Right ventricular myocardial infarction (RVMI) damages the systolic and diastolic functions of the RV, so the right atrium interacts with the RV with an acutely altered function. The aim of our study was to compare right atrial function as evaluated by 2D speckle-tracking echocardiography (2DSTE) between patients with inferior wall myocardial infarction (INFMI) and patients affected by both inferior myocardial infarction and right ventricular myocardial infarction (INFMI + RVMI). Our study recruited 70 consecutive patients with INFMI (43 patients without RVMI and 27 patients with RVMI). ⋯ The area under the curve for early diastolic strain for INFMI diagnosis was 0.682 (p value = 0.011, 95 % CI 0.550-0.815). Right atrial early diastolic longitudinal strain <27.5 % had 59.3 % sensitivity and 79.1 % specificity for the discrimination of INFMI + RVMI from INFMI. Our results demonstrated that right atrial reservoir and conduit functions were impaired in the patients with INFMI + RVMI compared with the patients with INFMI.
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Int J Cardiovasc Imaging · Jan 2017
Left ventricular torsion and circumferential strain responses to exercise in patients with ischemic coronary artery disease.
LV torsion during exercise in patients with coronary artery disease (CAD) is not well known. Circumferential strain (CS) and left ventricular (LV) torsion (Tor) have not been evaluated during ischemia in these patients. We aimed to assess the effect of ischemia during exercise echocardiography (ExE) on CS and Tor. ⋯ At exercise, all rotational and CS parameters were impaired in the ischemic in comparison with the control group (basal CS: -18 ± 5 vs. -25 ± 7 %, p < 0.001; apical CS: -31 ± 11 vs. - 43 ± 9 %, p < 0.001; time to basal CS: 52 ± 6 vs. 48 ± 7 %, p = 0.001; time to apical CS: 55 ± 7 vs. 49 ± 6 %, p < 0.001; basal rotation: -0.7 ± 6.5° vs. -6.2 ± 8.5°, p < 0.001; LV twist 13.0 ± 10.4° vs.19.7 ± 11.5°, p < 0.001; LV-Tor 1.9 ± 1.6°/cm vs. 2.8 ± 1.7˚/cm, p = 0.001) with the exception of apical rotation which was similar (12.3 ± 7.4° vs. 13.4 ± 7.7°, p = NS). Basal and apical CS and basal rotation impair during exercise-induced ischemia. LV-Tor decreases with ischemia due to worsening of basal rotation, whereas apical rotation does not impair, suggesting the existence of an apical compensatory mechanism.
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Int J Cardiovasc Imaging · Jan 2017
Diagnostic and prognostic value of right ventricular strain in patients with pulmonary arterial hypertension and relatively preserved functional capacity studied with echocardiography and magnetic resonance.
Right ventricular (RV) dysfunction harbingers adverse prognosis in pulmonary arterial hypertension (PAH). Although conventional two-dimensional echocardiography (2DE) is limited for RV systolic function quantitation, RV strain can be a useful tool. The diagnostic and prognostic impact of 2DE speckle-tracking RV longitudinal strain was evaluated, including other 2DE systolic indexes, in a group of PAH patients without severe impairment of functional capacity, chronic pulmonary thromboembolism or left ventricular dysfunction. ⋯ Combined endpoints occurred in 15 (22.7 %) patients (6 hospitalizations and 9 deaths). Multivariate analysis identified RVFreeWSt ≤-14 % as the only 2DE independent variable associated with combined endpoints [HR 4.66 (1.25-17.37); p < 0.05]. We conclude that RVFreeWSt may be a suitable non-geometric 2DE surrogate of CMR-RVEF in PAH patients, constituting a powerful independent predictor of long-term outcome in this cohort with relatively preserved functional capacity.